Donations can also be made online through The Dayton Foundation website (a 3.0% fee is assessed to the Fund). Go to www.kernfund.org, click on DONATE!, then click on Donate Online. |
|
| |
| Your Name: | ________________________________________
|
| Street Address, Line 1: | ________________________________________
|
| Street Address, Line 2, if any: | ________________________________________
|
| City, State/Province, Zip/Postal Code: | ________________________________________
|
| Preferred Phone No., with Area Code: | Home Bus. Cell |
| Your E-Mail Address: | ________________________________________
|
|
| Amount of Donation: | $ |
| Should this gift be anonymous?: |
NO YES |
| If NO, list how name(s) should appear: | ________________________________________
|
| |
| ==> Please complete the information below if you want this to be an honorary or memorial gift, which will be recognized online. You can also acknowledge this gift to individual(s) you specify plus add any comments on why you want to recognize this person. |
|
| Donation is in Honor Memory of: |
Name(s): ______________________________
|
Please acknowledge this gift to:
(Please enter name and address. If
you don't know the address, we'll try
to find it - just give us a few hints!) | |
Any comments on why you are
recognizing this person/these people?
(Use other side of printed form
if more space is needed): | |
| Keep these comments anonymous?: |
NO YES |
|
| |
For the most timely and accurate recording of your donation information on the Kern Fund web site,
please mail both this completed form and your check, made payable to The Carl B. Kern Fund, to: |
The Carl B. Kern Fund
c/o Stuart Weinberg
1207 Deanna Court
Franklin, TN 37067-8601 |
|
This form and your donation will then be forwarded to The Dayton Foundation.
** Thank you very much!! ** |